Healthcare Provider Details

I. General information

NPI: 1114569589
Provider Name (Legal Business Name): PARIS MOUNTAIN MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NEW ALTAMONT TER
GREENVILLE SC
29609-6234
US

IV. Provider business mailing address

5 NEW ALTAMONT TER
GREENVILLE SC
29609-6234
US

V. Phone/Fax

Practice location:
  • Phone: 864-999-0350
  • Fax:
Mailing address:
  • Phone: 864-999-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MS. JANELLE B ALIER
Title or Position: ADMINISTRATOR
Credential: CNM
Phone: 864-999-0350